Issue - Southern Medical Association

Editorial

Epstein-Barr Virus: The Spectrum of Its Manifestations in Human Beings

ABSTRACT: Epstein-Barr virus (EBV) infects virtually everyone by adulthood, and a lifelong latency is maintained. It infects children silently, whereas the majority of adolescents have infectious mononucleosis (IM). Children who have IM before 5 years of age are often heterophil negative; EBV-specific antibodies are required for diagnosis. On rare occasions…

Primary Article

Evaluation of Fever in Infants Less Than 8 Weeks Old

ABSTRACT: We evaluated fever in 342 hospitalized infants less than 8 weeks of age. Sixteen infants (5%) had bacteremia or bacterial meningitis. Fifty-two percent of the infants were admitted during the months of July through September. We found no significant relationship between season, sex, height of fever, or erythrocyte sedimentation…

Primary Article

Colorectal Cancer Mortality and Incidence in Campbell County, Kentucky

ABSTRACT: Previous publications have reported an unusually high colon cancer mortality rate for several Kentucky counties. We investigated these high rates by examining incidence of colorectal cancer in one county with a high mortality. The objective was to determine whether the incidence of colorectal cancer was as high as mortality…

Primary Article

Seasonal Variation of Acute Appendicitis: A 56-Year Study

ABSTRACT: Over a period of 56 years, 12,686 appendectomies were done for acute appendicitis at the Jersey City Medical Center in Jersey City, New Jersey. We tabulated each appendectomy by the month and season of its occurrence. The spring and summer months had the highest incidence and the fall and…

Primary Article

Eating Behavior After Gastric Bypass Surgery for Obesity

ABSTRACT: We studied eating behavior in two non-overlapping cohorts of consecutive patients electing gastric bypass surgery for obesity: 100 patients one year after operation and 60 patients three years afterward. Information was obtained through structured interviews and from office charts. Eating behavior was compared with previously collected data on 232…

Primary Article

Gallstones: A Comparison of Real-Time Ultrasonography and Cholecystography With Surgical Correlation

ABSTRACT: Real-time ultrasonography is more accurate and technically more efficient than gray scale ultrasonography in establishing the diagnosis of cholecystolithiasis. In prospective studies accuracy may be as high as 96%, and reflects the use of specific sonographic diagnostic criteria. Retrospective studies, however, reveal a lower accuracy rate of 90%, suggesting…

Primary Article

Myelodysplastic Syndrome: Identification in the Routine Hematology Laboratory

ABSTRACT: The Coulter S+IV electronically generates an automated white blood cell differential which counts 10,000+ cells per sample, separating lymphocytes, mononuclear cells, and granulocytes. In patients with preleukemic or so-called myelodysplastic syndromes, the histograms are consistently abnormal. CBCs of five patients demonstrate the variable features of myelodysplasia involving abnormal monocytosis,…

Primary Article

High Tibial Osteotomy: A Retrospective Review of 72 Cases

ABSTRACT: Past experience has shown that the results of high tibial osteotomy are difficult to predict. The purpose of this review was to correlate preoperative findings with postoperative results to define more precisely the indications and contraindications and to improve results. Between 1970 and 1983, 72 high tibial osteotomies for…

Primary Article

Supraglottitis in Young Adults

ABSTRACT: Supraglottitis is a disorder with the potential for significant morbidity and mortality in adults. Of the 25 patients we reviewed, 18 were black, representing the largest series of black adults with this condition reported in the medical literature. The mean age for black men was 14 years younger than…

Primary Article

Elective Cesarean Hysterectomy Versus Vaginal Hysterectomy for the Treatment of Cervical Intraepithelial Neoplasia

ABSTRACT: We retrospectively compared elective cesarean hysterectomy and vaginal hysterectomy for cervical intraepithelial neoplasia. Sixteen patients had cesarean hysterectomy and 53 had vaginal hysterectomy. There were no deaths in either group and no neonatal complications in the cesarean hysterectomy group. Major and minor complications were comparable in the two groups…

Primary Article

Vaginal Physiology in Postmenopausal Women: pH Value, Transvaginal Electropotential Difference, and Estimated Blood Flow

ABSTRACT: Basal vaginal physiologic study, including pH values in various locations, transvaginal electropotential difference, and blood flow estimation, was done twice in a group of 34 untreated postmenopausal women. Plasma hormone levels (gonadotropins and estrogens) and vaginal cytology were also obtained to confirm the estrogen deficiency state. The pH values…

Primary Article

Vulvar and Vaginal Hematomas: A Retrospective Study of Conservative Versus Operative Management

ABSTRACT: We reviewed 32 cases of vulvar and vaginal hematomas treated at three hospitals in Jacksonville, Florida, from March 1975 to March 1985. Patients ranged in age from 14 to 37 years. In 29 patients the hematomas resulted from obstetric trauma and in three from other causes. We found that…

Primary Article

Sexual Relationships of Patients With Kleptomania

ABSTRACT: Kleptomania, a disorder of impulse control in which the patients feel a compelling urge to steal objects of no value to them, has long been considered a disorder related in some fashion to sexual impulses. Recent advances in the clinical understanding of human sexual functioning have not been accompanied…

Review Article

Functional Hyposplenism

ABSTRACT: In the past 15 years, it has become increasingly evident that diverse conditions may be linked with hyposplenism and that hyposplenic individuals are susceptible to overwhelming infection, particularly by the encapsulated organisms such as pneumococci, meningococci, and Haemophilus influenzae. Identification of Howell-Jolly bodies in the peripheral blood smear is…

Current Concepts

Biliary Antibiotics: Clinical Utility in Biliary Surgery

Article

Downs Syndrome

ABSTRACT: We discuss the ethical, psychosocial, economic, and medical dimensions of the treatment and management of a child with Downs syndrome and a congenital heart defect.

Article

Dial M for MEDLINE: A How-to Guide for the Clinician

ABSTRACT: A medical librarian explains how clinicians can perform their own MEDLINE searches.

Medical Education

Selection of Anesthesiology Residents

ABSTRACT: The large numbers of medical graduates seeking residency training in anesthesiology have created a logistical problem for many programs. This difficulty and the recurrent phenomenon of the misplaced physician have prompted a search for better selection criteria and more efficient evaluation systems. The literature does not provide a concise…